TITLE:
Attainment of the Fifth Millennium Development Goal: Utopia or Reality Based on Trends in Maternal Mortality in 12 Years in Two Regional Hospitals in Fako Division, Cameroon? A Retrospective Study
AUTHORS:
Gregory Edie Halle Ekane, Thomas Egbe Obinchemti, Charlotte Nguefack Tchente, Lydia Kahgomia Fokunang, Theophile Nana Njamen, Ndamezie Nkafu Bechem, Martin Mafany Njie, Daniel Latum
KEYWORDS:
Maternal Mortality Ratio, Causes, Trends, MDG 5, South West Region
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.13,
September
17,
2014
ABSTRACT: Introduction: According to
WHO, globally an estimated 585,000 women die each year from complications of
pregnancy and childbirth. One of the targets of Millennium Development Goal 5 (MDG
5) is to reduce maternal mortality by three quarters of the 1999 value by the
year 2015. However, three years to 2015, very little is known on the trends in
maternal mortality ratio, causes of maternal deaths and their associated
factors in the Tiko Cottage Hospital (TCH) and Limbe Regional Hospital (LRH) in
the South-West Region, Cameroon. Methods: This was a retrospective, analytical
cross-sectional study that was carried out from 1st January 2000 to December 2012. After
obtaining ethical clearance, the records of cases of maternal deaths and a
reference group of women who survived after a pregnancy during the same period
were carefully reviewed. The data were analyzed with SPSS 10 and EPI 3.5.1.
Results: There were 14,480 live births and 132 maternal deaths during the study period, giving
an adjusted Maternal Mortality Ratio (MMR) of 892/100,000 live births. Patients’ age ranged from
15 - 40 years (SD 2.3). We observed a downwards trend of Maternal Mortality
Ratio (MMR). Seventy-eight percent of the maternal deaths were due to direct
causes. The triad of hemorrhage (54.5%), abortions (17.4%), and eclampsia
(10.6%) was the leading cause of death. HIV-related complications and hepatitis
constituted the main indirect causes of maternal death. In 85.4% of cases,
maternal deaths were avoidable. Lack of blood for transfusion and late referral
of cases were the main avoidable factors. Patients less than 35 years (p =
0.01), no antenatal care (ANC) (p = 0.001), unemployment [OR = 1.52; 95% CI:
(1.38 - 48.28); p = 0.02] were
significantly associated with maternal deaths while grand multiparity [OR =
1.20; 95% CI (0.30 - 4.86); p =
0.79], marital status [OR = 1.20; 95% CI: (0.70 - 2.07); p = 0.51] and
education level were not significantly associated with maternal deaths.
Conclusion: The trend shows that there was no appreciable decline in maternal
mortality, implying that attaining the objectives of MDG 5 is very unlikely.
Therefore, to meet the MDG 5 target, we recommend that, there should be
amelioration towards obstetric emergencies care and health education by health
care providers.